Suprapubic catheter care
SPT
When you enter a store or restaurant, are you often looking to find the establishments bathroom? If you're having trouble holding in your urine, or if you often leak urine, you probably have what's called urinary incontinence. Normally, the bladder begins to fill with urine from the kidneys. The bladder stretches to allow more and more urine. You should feel the first urge to urinate when there is about 200 mL, just under 1 cup of urine stored in your bladder. A healthy nervous system will respond to this stretching sensation by letting you know that you have to urinate. But, at the same time, the bladder should keep filling. But the system doesn't work correctly in people with urinary incontinence. Some people with urinary incontinence leak urine during activities like coughing, sneezing, laughing, or exercise. This is called stress incontinence. When you have a sudden, strong need to urinate, but can't make it to the bathroom before you do urinate, it's called urge incontinence. Other people have what's called overflow incontinence, when the bladder cannot empty and they dribble. Urinary incontinence can have many causes, and it's most common in older adults. Women are more likely than men to have it. For some people the bladder muscle is overactive. For others, the muscles holding the urine in are weak. And for others, the problem is sensing when the bladder is full. They might have brain or nerve problems, dementia or other health problems that make it hard to feel and respond to the urge to urinate, or problems with the urinary system itself. To treat urinary incontinence, your doctor can help you form a treatment plan. Most likely, exercises to strengthen the muscles of your pelvic floor will be part of that plan. Bladder training exercises can also be effective. And depending on the cause of incontinence, oral medications, or topical estrogen may be helpful. If you have overflow incontinence and cannot empty your bladder completely, you may need to use a catheter. Your doctor can recommend the best catheter for you. For urine leaks, you might wear absorbent pads or undergarments. Whatever else you try, lifestyle changes may help. Aim for an ideal weight. Losing excess weight and increasing exercise both often improve incontinence, especially in women. Also, some specific beverages and foods might increase leaking in some people. For instance, you might try eliminating alcohol, caffeine, carbonated beverages, even decaf coffee. Drink plenty of water, but do NOT drink anything 2 to 4 hours before going to bed. Be sure to empty your bladder before going to bed to help prevent urine leakage at night. Throughout the day, urinate at set times, even if you do not feel the urge. Schedule yourself every 3 to 4 hours. Urinary incontinence is very common, but many people never talk to their doctor about it. Don't let that be you. See your doctor and bring it up at your next doctor's visit.
What to Expect at Home
Your catheter will make it easier for you to drain your bladder and avoid infections. You will need to make sure it is working properly. You may need to know how to change it. The catheter will need to be changed every 4 to 6 weeks.
You can learn how to change your catheter in a sterile (very clean) way. After some practice, it will get easier. Your health care provider will change it for you the first time.
Sometimes family members, a nurse, or others may be able to help you change your catheter.
You will get a prescription to buy special catheters at a medical supply store. Other supplies you will need are sterile gloves, a catheter pack, syringes, sterile solution to clean with, gel such as K-Y Jelly or Surgilube (do not use Vaseline), and a drainage bag. You may also get medicine for your bladder.
Drink 8 to 12 glasses of water every day for a few days after you change your catheter. Avoid physical activity for a week or two. It is best to keep the catheter taped to your belly.
Once your catheter is in place, you will need to empty your urine bag only a few times a day.
Caring for Your Skin Near your Catheter
Follow these guidelines for good health and skin care:
- Check the catheter site a few times a day. Check for redness, pain, swelling, or pus.
- Wash the area around your catheter every day with mild soap and water. Gently pat it dry. Showers are fine. Ask your providers about bathtubs, swimming pools, and hot tubs.
- Do not use creams, powders, or sprays near the site.
- Apply bandages around the site the way your provider showed you.
Make Sure Your Catheter Is Working
You will need to check your catheter and bag throughout the day.
- Make sure your bag is always below your waist. This will keep urine from going back into your bladder.
- Try not to disconnect the catheter more than you need to. Keeping it connected will make it work better.
- Check for kinks, and move the tubing around if it is not draining.
Changing Your Catheter
You will need to change the catheter about every 4 to 6 weeks. Always wash your hands with soap and water before changing it.
Once you have your sterile supplies ready, lie down on your back. Put on two pairs of sterile gloves, one over the other. Then:
- Make sure your new catheter is lubricated on the end you will insert into your belly.
- Clean around the site using a sterile solution.
- Deflate the balloon with one of the syringes.
- Take out the old catheter slowly.
- Take off the top pair of gloves.
- Insert the new catheter as far in as the other one was placed.
- Wait for urine to flow. It may take a few minutes.
- Inflate the balloon using 5 to 8 ml of sterile water.
- Attach your drainage bag.
If you are having trouble changing your catheter, contact your provider right away. Insert a catheter into your urethra through your urinary opening between your labia (women) or in the penis (men) to pass urine. Do not remove the suprapubic catheter because the hole in your belly can close up quickly. However, if you have removed the catheter already and cannot get it back in, call your provider or go to the local emergency room.
When to Call the Doctor
Contact your provider if:
- You are having trouble changing your catheter or emptying your bag.
- Your bag is filling up quickly, and you have an increase in urine.
- You are leaking urine.
- You notice blood in your urine a few days after you leave the hospital.
- You are bleeding at the insertion site after you change your catheter, and it does not stop within 24 hours.
- Your catheter seems blocked.
- You notice grit or stones in your urine.
- Your supplies do not seem to be working (balloon is not inflating or other problems).
- You notice a smell or change in color in your urine, or your urine is cloudy.
- You have signs of infection (a burning sensation when you urinate, fever, or chills).
References
Dauw CA, Wolf JS. Fundamentals of upper urinary tract drainage. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 12.
Davis JE, Silverman MA. Urologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 55.
James RE, Palleschi JR. Suprapubic catheter insertion and/or change. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 99.
Version Info
Last reviewed on: 1/1/2025
Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
